Okamoto Y
Gifu Shika Gakkai Zasshi. 1989 Dec;16(2):470-84.
Tipping movement in orthodontic therapy, which is often performed even in the absence of the adjacent tooth, is represented by the movement following tooth extraction. Such tipping movement in the absence of the adjacent tooth depends not only upon the magnitude of orthodontic force as classified into Stoner 4D, but also upon the condition of the extracted wounds. To evaluate the clinical applicability of HAp-packing used in combination with tipping movement, histopathological investigation was performed in the periodontal tissue with tipping movement toward the adjacent to HAp-packed socket. HAp packing into the extracted wound cavity produced no significant changes in quantitative tipping movement compared with non-HAp packing. HAp packing into the extracted wound cavity, followed by tipping movement, produced compressed sides not only for the moved tooth but also for the anchor tooth. Resorption and disappearance of alveolar septum were observed on the compressed sides of both these teeth for all experimental sides. HAp in an amount enough to meet the narrowing of the extracted wound cavity, associated with tipping movement was discharged from the suture surface. In the same region, fibrous connective tissue lay between the dental root and the HAp mass, which were not adjacent to each other. The fibrous connective tissue presented temporal bone regeneration so as to surround the tooth. Apart from the moving distance, the tissue change showed no essential difference either for a weak force or for a strong force. The above results revealed the usefulness of HAp packing into the extracted wound cavity for tipping movement of the adjacent tooth in the direction of the wound cavity and immediate move ability after extraction.
正畸治疗中的倾斜移动,即使在没有邻牙的情况下也经常进行,其表现为拔牙后的牙齿移动。在没有邻牙的情况下,这种倾斜移动不仅取决于分类为斯托纳4D的正畸力的大小,还取决于拔牙创口的状况。为了评估与倾斜移动联合使用的羟基磷灰石(HAp)填充的临床适用性,对向HAp填充牙槽窝的邻牙进行倾斜移动的牙周组织进行了组织病理学研究。与未使用HAp填充相比,向拔牙创腔内填充HAp在定量倾斜移动方面没有产生显著变化。向拔牙创腔内填充HAp后进行倾斜移动,不仅使移动牙产生压缩侧,也使支抗牙产生压缩侧。在所有实验侧,这两颗牙的压缩侧均观察到牙槽间隔的吸收和消失。与倾斜移动相关的、足以满足拔牙创腔变窄的HAp量从缝合面排出。在同一区域,牙根与HAp团块之间存在纤维结缔组织,二者并不相邻。纤维结缔组织呈现出颞骨再生,从而包围牙齿。除移动距离外,弱力或强力作用下的组织变化没有本质区别。上述结果揭示了向拔牙创腔内填充HAp对于邻牙向创腔方向倾斜移动以及拔牙后立即移动的有效性。